Medicare Part D

Extra Help in Scottsbluff: Lower Part D Drug Costs in 2026

For Medicare beneficiaries in Scottsbluff, prescription drug costs can be one of the trickiest parts of the budget. But a federal program called Extra Help — also known as the Low-Income Subsidy, or LIS — is designed to make Part D drug coverage more affordable for people with limited income and resources. And in 2026, it works alongside a new $2,100 yearly cap on what anyone with Part D pays out of pocket for covered drugs.

If money is tight, Extra Help is worth a close look. Here's how it works and how Scottsbluff residents can find out if they qualify.

What Extra Help actually does

Extra Help is a program run by Social Security and Medicare that helps pay for a Medicare Part D drug plan. If you qualify, it can lower or eliminate your Part D monthly premium, cut your annual deductible, and reduce the copays you pay at the pharmacy for covered prescriptions.

According to CMS — Medicare Part D program rules (medicare.gov), Extra Help is now a single, full-benefit level. That change, which took effect in 2024, expanded the program so more people with modest incomes get the full subsidy instead of a partial one.

Who qualifies in 2026

You may qualify for Extra Help if your income and resources fall below the limits Social Security sets each year. Generally, the program is aimed at people with incomes at or below 150% of the federal poverty level, with limited savings and other assets.

A few things to keep in mind:

• Your home, your car, and personal belongings don't count toward the resource limit.
• If you already have Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program, you automatically get Extra Help — you don't need to apply.
• Even if you've been turned down before, it's worth reapplying, because the rules and limits change.

For the current year's income and resource figures, check ssa.gov/extrahelp or call Social Security at 1-800-772-1213.

How Extra Help fits with the 2026 drug cost changes

Starting in 2025, Medicare eliminated the old "donut hole" coverage gap and moved Part D to a simpler three-phase design. In 2026, the annual out-of-pocket cap on covered Part D drugs rises to $2,100, and the maximum Part D deductible any plan can charge is $615.

Extra Help sits on top of these protections. If you qualify, your costs during the year are already reduced — often far below that $2,100 ceiling — because your copays and premiums are lower to begin with.

There's also the Medicare Prescription Payment Plan, a separate option that lets any Part D enrollee spread out-of-pocket drug costs across the calendar year in monthly installments. It doesn't lower your total cost, but it can smooth out a big pharmacy bill.

Part D availability in Scotts Bluff County

Scottsbluff is in Scotts Bluff County, where Medicare beneficiaries can choose from a range of stand-alone Part D drug plans and Medicare Advantage plans that include drug coverage. Plan choices, formularies, and pharmacy networks vary, so it's important to compare options during the Annual Enrollment Period, which runs October 15 through December 7. If you're already in a Medicare Advantage plan, you also have the Medicare Advantage Open Enrollment Period from January 1 through March 31 to make a one-time change.

Extra Help qualifiers get an added benefit: a Special Enrollment Period that allows you to change your Part D plan outside these normal windows.

How to apply from Scottsbluff

There are three straightforward ways to apply for Extra Help: 1. Online: ssa.gov/extrahelp — the form takes about 10 minutes. 2. By phone: Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778). 3. In person or with help: Nebraska SHIP counselors offer free, one-on-one assistance for Scottsbluff residents. They don't sell plans and don't work on commission.

Applying is free. Be cautious of anyone who charges a fee or asks for payment to file an Extra Help application on your behalf.